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Even though Congress pumped an extra US$109 million into the public health IT infrastructure in this year’s federal budget, the nation’s state and local public health departments need at least 10 times that to meet anticipated demands.

It will take at least $1 billion in funding over 15 years to deploy networks and information systems designed to coordinate responses to a bio-terrorism attack or major epidemic, according to federal and state public health officials.

The Centers for Disease Control and Prevention (CDC) in Atlanta expects to use the emergency funding within the next year to connect state and local public departments serving 90 percent of the population to the nationwide CDC-managed Health Alert Network (HAN).

That will be an improvement from March 2001, when the CDC put out a report that compared the U.S.’s public health IT infrastructure to a “pony express system” that relied on paper reports and phone calls in an Internet world. When the report was released, only about half of the country’s 59 state and territorial health departments and 6,000 local health boards had full-time Internet connectivity, and another 20 percent lacked e-mail.

Dr. Ed Baker, an assistant surgeon general in the U.S. Public Health Service who manages the CDC’s Public Health Practice Office, called the $109 million in supplemental funding a modest investment in the public health IT infrastructure, whose capital costs he estimated at $1 billion plus “ongoing costs for maintaining and improving it.”

Dr. Georges Benjamin, secretary of the Maryland Department of Health and Mental Hygiene, considers the emergency funding a down payment. “This is just the first wave of funding. It’s going to take a long and sustained effort to make it work,” he said.

Benjamin, who also serves as president of the Association of State and Territorial Health Officials (ASHTO) in Washington, said it “will take 15 years to put these [public health IT] systems in place.”

The population-based distribution of the IT infrastructure funds by the CDC works to the detriment of rural states such as Iowa. Dr. Patricia Quinlisk, Iowa’s epidemiologist, said she is still using the postal system to send lab reports. But, she added, the new funding will provide Iowa with “desperately needed resources” for IT infrastructure.

Baker emphasized that HAN is far more than a computer network: It’s designed to deliver critical information to public health care professionals to help battle everything from food poisoning to anthrax attacks. Computer-based training and video to the desktop are essential to this effort, he said.

Data on the Fly

HAN funding is also used to deploy graphical systems that present information in ways that can be quickly grasped by harried doctors in the midst of a crisis, according to Elana Knudsen-Buresh, senior director of public health infrastructure policy at ASHTO.

Benjamin said such tools will help boost the capabilities of public health departments, which have struggled with inadequate systems for years. However, in order to ensure that agencies get the systems they need, Congress must keep the funds flowing, he said.

Last October’s anthrax attacks highlighted the importance of public health agencies and their need for advanced technology. But Benjamin said he’s worried the funding could disappear once again, “because we are a nation with a very short memory.”